Does Nova Scotia’s Mental Health Legislation Meet Its Goals? Jordan Sheriko November 15, 2005

A Little Background The Hospitals Act was enacted in 1977 and contains provisions for mental health. The Hospitals Act was enacted in 1977 and contains provisions for mental health. A review of the mental health system began in 1999 as part of the Conservative party platform. A review of the mental health system began in 1999 as part of the Conservative party platform. In 2001 the Department of Health recommended that new legislation for mental health be created. In 2001 the Department of Health recommended that new legislation for mental health be created.

Background Cont. January 2002 the Mental Health Legislation Development Committee was formed. January 2002 the Mental Health Legislation Development Committee was formed. In 2003 the government released its strategic directions and standards of mental health care. In 2003 the government released its strategic directions and standards of mental health care. In march of 2004 the Committee presented its mental health legislation discussion paper. In march of 2004 the Committee presented its mental health legislation discussion paper.

Need for Change The treatment and care of mentally ill patients has been rapidly evolving as new research uncovers more effective treatments to mental disorders The treatment and care of mentally ill patients has been rapidly evolving as new research uncovers more effective treatments to mental disorders The current legislation does not reflect the trend of deinstitutionalization and more community based services The current legislation does not reflect the trend of deinstitutionalization and more community based services In a 2003 publication the World Health Organization states: “ In a 2003 publication the World Health Organization states: “Mental health legislation should be viewed as a process rather than an event that occurs just once in many decades”

The Government’s stance on mental health Mental Health Vision: Mental Health Vision: “ “Our vision of the mental health of Nova Scotians is one in which consumers and communities can attain their optimal level of mental health. Programs and services will run the gamut from mental health promotion to acute care. They will be unified, coordinated, flexible, offered on a district basis and geared to the needs and desires of the consumer.”

Mental Health Core Values Focus on communities and consumers of mental health services. Direct involvement in planning, implementation, and monitoring the mental health system. Focus on communities and consumers of mental health services. Direct involvement in planning, implementation, and monitoring the mental health system. Equal access to services Equal access to services The best mental health practices must be based on sound evidence The best mental health practices must be based on sound evidence The mental health system should be integrated with the overall health system The mental health system should be integrated with the overall health system

What the government is doing right In 2004 the Canadian Mental Health Association (CMHA) released its report card on the state of the mental health system. In 2004 the Canadian Mental Health Association (CMHA) released its report card on the state of the mental health system. - the association gave the government an A for introducing positive standards and strategic directions to improve the state of mental health services in the province. - the association gave the government an A for introducing positive standards and strategic directions to improve the state of mental health services in the province.

What the government is doing right Nova Scotia is the first province to adopt a set of standards for mental health Nova Scotia is the first province to adopt a set of standards for mental health These standards were developed with input from all stakeholders. Including mental health professionals and community members These standards were developed with input from all stakeholders. Including mental health professionals and community members

Criticisms of the Government The CMHA does not support the new Mental Health legislation because “ The CMHA does not support the new Mental Health legislation because “the Act is regressive in nature in that it fails to protect the charter rights of individuals with respect to human rights and individual dignity.” The CMHA also gave the government an overall grade of “E for effort” The CMHA also gave the government an overall grade of “E for effort” The CMHA criticizes the government for its lack of funding to fulfill its standards and goals The CMHA criticizes the government for its lack of funding to fulfill its standards and goals The lack of funding was highlighted in the budget when 3.8% of the total health care budget was devoted to mental health. The lack of funding was highlighted in the budget when 3.8% of the total health care budget was devoted to mental health.

Criticisms of the Government The lack of funding to support the governments standards of mental health care raise the question of how committed the government is to these standards. The lack of funding to support the governments standards of mental health care raise the question of how committed the government is to these standards. The standards call for greater community based services, however the distribution of funding does not reflect this desire The standards call for greater community based services, however the distribution of funding does not reflect this desire

Graduate Work Can obtain a MSc in clinical psychology from Acadia Can obtain a MSc in clinical psychology from Acadia Dalhousie offers a PhD in clinical psychology Dalhousie offers a PhD in clinical psychology People who have worked on mental health legislation in Nova Scotia: People who have worked on mental health legislation in Nova Scotia: -Dr. Brian Dufton – Clinical psychologist -Dr. Brian Dufton – Clinical psychologist -Sheila Wildeman – Assistant professor of law at Dalhousie University -Sheila Wildeman – Assistant professor of law at Dalhousie University - -Archie Kaiser - Professor, Dalhousie University Law School and Department of Psychiatry -Carol Tooton, Executive Director, Canadian Mental Health Association, Nova Scotia Division

References CMHANS. An E for effort, an F for Funding of Core Mental Health Standards. March 11, CMHANS report card on mental health services core standards. March 8, CMHANS. An act to promote mental health and community participation in Nova Scotia: a discussion paper. December CMHANS. Mental Health Act – Bill 109 – Currently Before the House Flawed. October 7, Mental Health Legislation Development Committee. Mental health legislation discussion paper. March Department of Health. Strategic Directions for Nova Scotia’s Mental Health system. February 20, Department of Health. Standards for Mental Health Services in Nova Scotia. March 22, Bland, Dr. R, Dufton, Dr. B. Mental Health: A Time for Action. May 31, World Health Organization. Resource Book on Mental Health, Human Rights, and Legislation

Discussion Do you feel that the mental health services in Nova Scotia are adequate? Do you feel that the mental health services in Nova Scotia are adequate? Will increased funding alone improve the delivery of services or is new legislation vitally important? Will increased funding alone improve the delivery of services or is new legislation vitally important?